RESUMEN
Septic arthritis is not a frequent, but quite classical pathology in children. It can be followed by a severe outcome in case of delayed and/or inadequate treatment. The drainage of the infected joint associated with a prompt and adapted antibiotherapy are together the cornerstones of this treatment. The isolation and identification of the causative microorganism is also of the highest importance. Up to now, unfortunately, a large proportion of septic arthritis are treated by antibiotics although all culture remain negative. This paper has two objectives: one is to present the different steps to optimize the assessment and diagnosis; the second, to increase the sensitivity of the pathogen identification. At last, we present our proposal for empirical antibiotherapy.
Asunto(s)
Artritis Infecciosa/diagnóstico , Artritis Infecciosa/tratamiento farmacológico , Antibacterianos/administración & dosificación , Preescolar , Quimioterapia Combinada , Femenino , Floxacilina/administración & dosificación , Humanos , Rifampin/administración & dosificación , Líquido Sinovial/microbiologíaAsunto(s)
Absceso Encefálico/diagnóstico , Neuroaspergilosis/diagnóstico , Absceso Encefálico/líquido cefalorraquídeo , Diagnóstico Diferencial , Educación Médica Continua , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neuroaspergilosis/líquido cefalorraquídeo , Radiografía Torácica , Recurrencia , Tomografía Computarizada por Rayos XRESUMEN
We report the case of a 47 year old patient who had been suffering from persistent cough for more than three weeks. Patient coughed predominantly during night time, without fever. The amoxicillin-clavulanic acid initially prescribed was not effective. A series of complementary investigations were performed before serology finally identified Bordetella pertussis infection after two months of symptoms which improved slowly without evident benefit of macrolide treatment. The diagnosis of whooping cough was also established for the wife of the patient with fast resolution of the symptoms after rapid unset of treatment with macrolides.